| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 100 OTTAWA AVE., SW GRAND RAPIDS, MI 49503 | CALIFORNIA PHYSICIANS' SERVICE | — | $136K | $136K | 5.26% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA | 5664 PRAIRE CREEK DRIVE SE CALEDONIA, MI 49316 | KAISER FOUNDATION HEALTH PLAN, INC. | $65K | — | $65K | 5.02% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 16835 W BERNARDO DRIVE 212 SAN DIEGO, CA 92127 | FOUR EVER LIFE INS CO. | $24K | — | $24K | 8.07% |
| ANTHEM INSURANCE COMPANIES, INC.3 Filed as: ANTHEM INSURANCE COMPANIES | 120 MONUMENT CIRCLE INDIANAPOLIS, IN 46204 | FOUR EVER LIFE INS CO. | — | $3K | $3K | 1.00% |
| ACRISURE LLC3 Filed as: ACRISURE PTNRS WEST COAST INS SVCS | 3155 OLSEN DR, STE 400 SAN JOSE, CA 95117 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 12.41% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $1K | $1K | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 1950 W CORPORATE WAY #1 ANAHEIM, CA 92801 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $222 | — | $222 | 1.05% |
| ACRISURE LLC3 Filed as: ACRISURE PTNRS WEST COAST INS SVCS | 3155 OLSEN DR STE 400 SAN JOSE, CA 95117 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $744 | — | $744 | 11.74% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $317 | $317 | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 1950 W CORPORATE WAY #1 ANAHEIM, CA 92801 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $62 | — | $62 | 0.98% |
| ACRISURE LLC3 Filed as: ACRISURE PTNRS WEST COAST INS SVCS | 3155 OLSEN DR STE 400 SAN JOSE, CA 95117 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $729 | — | $729 | 11.70% |
| GROUP BENEFITS LTD3 | 12006 RIDGEMONT DR URBANDALE, IA 50323 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $312 | $312 | 5.01% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA LLC | 1950 W CORPORATE WAY #1 ANAHEIM, CA 92801 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $59 | — | $59 | 0.95% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 292 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 292 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 209 | $3.9M |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 71 | $6K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 43 | $6K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 42 | $21K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 209 | $2.6M |
| Other(2 contracts, 2 carriers) | FOUR EVER LIFE INS CO. | 71 | $304K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 209 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.